Concerns raised as opioid prescriptions rise across UK

Researchers supported by the NIHR Oxford Biomedical Research Centre(BRC) have recommended greater action to promote best practice, as a new study revealed a rise in prescriptions of opioids for treating chronic pain over thepast 20 years.

The research reviewing
opioid prescribing, published in the Lancet
Psychiatry, showed that UK doctors are prescribing more and stronger opioid
drugs to patients: there was a 34% rise between 1998 and 2016, which, when
corrected for total oral morphine equivalency, increased to 127%.

Credit – Kurtis Garbutt via Flickr

However, the
study also showed a decline in prescriptions between 2016 and 2017.

The research revealed a wide variation in opioid prescribing across the country, with the highest prescribers in northern and coastal areas and the lowest in Greater London. Larger practice list size, rural location and deprivation are all also associated with greater high-dose prescribing rates.

Ben
Goldacre, Senior Clinical Research Fellow from Oxford University’s Nuffield
Department of Primary Care Health Sciences, who led the study, said: “The US is
in the middle of an opioid crisis. UK use has not yet matched that scale, but
our work shows that close monitoring is needed.

“This is why
we have shared all our tools on OpenPrescribing.net.
Our website is open to all, allowing clinicians and others to see what
individual practices and regions are prescribing. High prescribers are not
necessarily bad prescribers: they may, for example, specialise in treating
substance misuse. But thoughtful data monitoring is key, to ensure problems are
not missed.

“Taking
greater action to promote best practice, such as prescribing lower doses for a
shorter duration, could also save substantial NHS resources. If every practice
changed their prescribing of high-dose opioids to match practices at the lowest
10%, this could save 543,000 high-dose prescriptions over six months.”

The study –
based on all prescribing data in the NHS from 1998-2018 – is the largest and
most comprehensive opioid trends study to date, and is accompanied by a live tool for anyone
to check the latest info on their practice or CCG.

The study
and tool were created by the DataLab at the
University of Oxford, which is headed by Dr Ben Goldacre. The DataLab is a
multidisciplinary team of clinicians, academics and software engineers: they
build interactive data-driven tools for the NHS and academia, as well as pure
academic papers.

As well as Oxford BRC,
the study was funded by
the NIHR School of Primary Care Research and NHS England.